what is Pulse.It is the peripheral feeling of heart beat.Normally pulse is felt at wrist joint, but it can be felt at any point where artery passes superficially over a bony surface.
Deduction of pulse
- Rate of pulse
- Condition of arterial wall.
For nurse and doctor the rate of pulse is usually measured and recorded in chart.
- Physical activity: Especially strenuous work done by an individual make his heart beat faster. When a person is at rest or at sleep, the pulse rate is lower than when he is awake.
- Fear, excitement and anger increases pulse rate.
- Certain drugs can either increase or decrease pulse rate.
- Usually infections raise body temperature and pulse rate also increases in proportion to temperature. Normally for each 1 degree Fahrenheit rise of temperature pulse rises by 10 beats. At I00°F temperature pulse becomes 100/minute.
- Next for 1°F rise in temperature pulse becomes 110, for 120°F body temperature pulse should be around 120. This pulse temperature relation reverses in certain viral fevers and also in enteric fever. Such condition is known as ‘Relative Bradycardia’. In such fevers as the temperature increases the pulse relatively becomes slower.
- Volume of blood—When blood volume decreases due to blood loss or fluid loss may be due to haemorrhage, dehydration or severe bums etc., the pulse rate increases.
- Pressure of blood—When blood pressure falls due to some reason, pulse rate increases initially and when blood pressure increases or in hypertensive patient pulse rate remains slow.
- Non/inflammatory Diseases—Like thyrotoxicosis, heart diseases, pulse increases.
Every Medical Student Must Know What Is Pulse In Human Body
Normal pulse rate varies between 60 to 80 per minutes in adult. The variation in normal healthy person occurs in following conditions
- Age : It is slower in adult, still slower in old age. It is fast in children and still faster in lower age group of children may be 100-130 per minutes.
- Sex : It is lower in men 60-75 per minutes than in women 7t-85 per minute.
- Stature s Slower in tall persons than in short persons.
- Position : It is slower during rest and sleep. It is slower in sitting position than standing.
- Emotion : Anger, excitement, fear and during inter course pulse rate increases.
Rhythm of Pulse
The rhythm of pulse refers to time interval between the beats. A normal rhythm has the same time spacing between two beats. This is known as regular rhythm. If the spacing between two beats is not at regular interval then it is designated as irregular rhythm. The rhythm becomes irregular in certain heart diseases.
Character of Pulse : The character or form of pulse cannot be properly assessed by nursing staff. There are certain heart diseases where the character of pulse changes. The character of pulse can be designated as of small amplitude as in aortic stenosis great amplitude as in aortic incompetence or water hammer type or collapsing type.
Volume of pulse : This is the amplitude of movement of vessel wall during passage of blood or pulse wave. A pulse of large volume is found after physical exertion and in high fever. Pulse of small volume is sound in haemorrhage and dehydration.
Condition of Arterial Wall
This requires practice to assess condition of arterial wall by feeling pulse Sufficient pressure should be exerted to empty blood from vessel and then the vessel rolled under the finger over the bony surface.. In young persons arteries cannot be felt or are felt very soft. In older persons the arteries are easily felt as firm cord like structure. In disease like arteriosclerosis, arteries are felt hard or cord like.
Procedure of Counting Pulse
- It is always better to record pulse at different sites. Both radial and brachial pulse should be recorded.
- Do not give more pressure.
- Do not use thumb to feel pulse as the thumb has.puise ox us own and it will interfere in correct recording.
- Use three finger tips for feeling pulse—index, middle and ring-finger.
- Pulse is best felt when patient’s forearm is pronated and wrist slightly flexed.
- Put the patient at ease by explaining what you are going to do.
- The patient can sit or lie down.
- The forearm should be always supported on pillow or by your hand.
- Place three fingers over radial artery at lateral side above wrist joint.
- Record pulse for full one minute, never take for 15 seconds and multiplying by four.If apical and radial pulse are to be taken, put stethoscope over apex of heart and listen and count. If there is difference in apex beat and radial pulse, note it down. This is known as pulse deficit.
- On graph only rate is noted. In personal note-book other abnormalities if detected should be noted and informed to senior staff.